PNLE: Community Health Nursing Exam 5

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PNLE: Community Health Nursing Exam 5 (PM)

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Question 1

A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds?

A

3

B

8

C

5

D

10

Question 1 Explanation:

Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.

Question 2

MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?

A

I

B

IV

C

II

D

III

Question 2 Explanation:

Waterworks systems, such as MWSS, are classified as level III.

Question 3

In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?

A

Mastoiditis

B

Severe febrile disease

C

Severe dehydration

D

Severe pneumonia

Question 3 Explanation:

The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or effective, tehn urgent referral to the hospital is done.

Question 4

You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.

A

50

B

45

C

60

D

55

Question 4 Explanation:

To estimate the number of infants, multiply total population by 3%.

Question 5

A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the first trimester of pregnancy in the barangay?

A

Consult at the health center where rubella vaccine may be given.

B

Avoid crowded places, such as markets and moviehouses.

C

Consult a physician who may give them rubella immunoglobulin.

D

Advice them on the signs of German measles.

Question 5 Explanation:

Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to pregnant women.

Question 6

The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?

A

Stream clearing

B

Zooprophylaxis

C

Destruction of breeding places

D

Stream seeding

Question 6 Explanation:

Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito

Question 7

You were invited to be the resource person in a training class for food handlers. Which of the following would you emphasize regarding prevention of staphylococcal food poisoning?

A

Food must be cooked properly to destroy staphylococcal microorganisms.

B

All cooking and eating utensils must be thoroughly washed.

C

Proper handwashing during food preparation is the best way of preventing the condition.

D

Food handlers and food servers must have a negative stool examination result.

Question 7 Explanation:

Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the microorganisms themselves. Contamination is by food handling by persons with staphylococcal skin or eye infections.

Question 8

Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs.

A

They shorten the period of communicability of the disease.

B

They reduce the risk of opportunistic infections

C

They prolong the life of the client with AIDS.

D

They are able to bring about a cure of the disease condition.

Question 8 Explanation:

There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life, but does not cure the underlying immunodeficiency.

Question 9

Among the following diseases, which is airborne?

A

Measles

B

Diphtheria

C

Viral conjunctivitis

D

Acute poliomyelitis

Question 9 Explanation:

Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is spread through the fecal-oral route and contact with throat secretions, whereas diphtheria is through direct and indirect contact with respiratory secretions.

Question 10

When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is

A

I

B

IV

C

II

D

III

Question 10 Explanation:

A communal faucet or water standpost is classified as Level II.

Question 11

For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?

A

Use of sterile syringes and needles

B

Safe food preparation and food handling by vendors

C

Proper disposal of human excreta and personal hygiene

D

Immediate reporting of water pipe leaks and illegal water connections

Question 11 Explanation:

Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.

Question 12

To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?

A

Community survey

B

Contact tracing

C

Interview of suspects

D

Mass screening tests

Question 12 Explanation:

Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.

Question 13

Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?

A

Stream clearing

B

Destruction of breeding places

C

Stream seeding

D

Zooprophylaxis

Question 13 Explanation:

Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing infection of humans.

Question 14

What is the most effective way of controlling schistosomiasis in an endemic area?

A

Use of protective footwear, such as rubber boots

B

Proper use of sanitary toilets

C

Use of molluscicides

D

Building of foot bridges

Question 14 Explanation:

The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts.

Question 15

A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?

A

Leptospirosis

B

Hepatitis A

C

Tetanus

D

Hepatitis B

Question 15 Explanation:

Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.

Question 16

You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take?

A

Ask the client to be accompanied by a significant person before revealing the result.

B

Get a thorough history of the client, focusing on the practice of high risk behaviors.

C

Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.

D

Refer the client to the physician since he is the best person to reveal the result to the client.

Question 16 Explanation:

A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ELISA result was false and that, most probably, the client is not infected.

Question 17

The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsillopharyngitis?

The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.

A

Nasal mucosa

B

Skin on the antecubital surface

C

Skin on the abdomen

D

Buccal mucosa

Question 18 Explanation:

Koplik’s spot may be seen on the mucosa of the mouth or the throat.

Question 19

Complications to infectious parotitis (mumps) may be serious in which type of clients?

A

Young infants

B

Young adult males

C

Pregnant women

D

Elderly clients

Question 19 Explanation:

Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.

Question 20

Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?

A

Neisseria meningitidis

B

Morbillivirus

C

Steptococcus pneumoniae

D

Hemophilus influenzae

Question 20 Explanation:

Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution is not specific in young children.

Question 21

In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?

A

Chicken pox vaccine is best given when there is an impending outbreak in the community.

B

To prevent an outbreak in the community, quarantine may be imposed by health authorities.

C

A single attack of chicken pox will prevent future episodes, including conditions such as shingles.

D

The older one gets, the more susceptible he becomes to the complications of chicken pox.

Question 21 Explanation:

Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.

Question 22

A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The client is most probably suffering from which condition?

A

Giardiasis

B

Amebiasis

C

Dysentery

D

Cholera

Question 22 Explanation:

Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea.

Question 23

In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?

A

Liver cirrhosis

B

Bladder cancer

C

Liver cancer

D

Intestinal perforation

Question 23 Explanation:

The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver.

Question 24

Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?

A

MMR

B

Measles vaccine

C

Oral polio vaccine

D

DPT

Question 24 Explanation:

DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccine are highly sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on Immunization.

Question 25

Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?

A

Seeding of breeding places with larva-eating fish

B

Use of mosquito-repelling soaps, such as those with basil or citronella

Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.

Question 27

In the Philippines, which specie of schistosoma is endemic in certain regions?

A

S. malayensis

B

S. japonicum

C

S. mansoni

D

S. haematobium

Question 27 Explanation:

S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S. malayensis only in peninsular Malaysia.

Question 28

A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?

A

Instruct the mother to give the child Oresol.

B

Start the patient on intravenous fluids STAT.

C

Insert an NGT and give fluids per NGT.

D

Refer the client to the physician for appropriate management.

Question 28 Explanation:

Since the child does not manifest any other danger sign, maintenance of fluid balance and replacement of fluid loss may be done by giving the client Oresol.

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PNLE: Community Health Nursing Exam 5 (EM)

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Choose the letter of the correct answer. You got 28 minutes to finish the exam .Good luck!

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Congratulations - you have completed PNLE: Community Health Nursing Exam 5 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs.

A

They are able to bring about a cure of the disease condition.

B

They prolong the life of the client with AIDS.

C

They reduce the risk of opportunistic infections

D

They shorten the period of communicability of the disease.

Question 1 Explanation:

There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life, but does not cure the underlying immunodeficiency.

Question 2

Which is the BEST control measure for AIDS?

A

Making sure that one’s sexual partner does not have signs of AIDS

B

Being faithful to a single sexual partner

C

Avoiding sexual contact with commercial sex workers

D

Using a condom during each sexual contact

Question 2 Explanation:

Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.

Question 3

When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is

A

II

B

I

C

III

D

IV

Question 3 Explanation:

A communal faucet or water standpost is classified as Level II.

Question 4

In the Philippines, which specie of schistosoma is endemic in certain regions?

A

S. japonicum

B

S. haematobium

C

S. mansoni

D

S. malayensis

Question 4 Explanation:

S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S. malayensis only in peninsular Malaysia.

Question 5

You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.

A

45

B

55

C

50

D

60

Question 5 Explanation:

To estimate the number of infants, multiply total population by 3%.

Question 6

A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The client is most probably suffering from which condition?

A

Cholera

B

Dysentery

C

Giardiasis

D

Amebiasis

Question 6 Explanation:

Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea.

Question 7

Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?

A

Stream seeding

B

Destruction of breeding places

C

Zooprophylaxis

D

Stream clearing

Question 7 Explanation:

Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing infection of humans.

Question 8

Complications to infectious parotitis (mumps) may be serious in which type of clients?

A

Elderly clients

B

Young infants

C

Pregnant women

D

Young adult males

Question 8 Explanation:

Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.

Question 9

A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?

A

Tetanus

B

Leptospirosis

C

Hepatitis B

D

Hepatitis A

Question 9 Explanation:

Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.

Question 10

Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?

A

Destruction of breeding places of the mosquito vector

B

Use of chemically treated mosquito nets

C

Use of mosquito-repelling soaps, such as those with basil or citronella

A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the first trimester of pregnancy in the barangay?

A

Consult a physician who may give them rubella immunoglobulin.

B

Consult at the health center where rubella vaccine may be given.

C

Avoid crowded places, such as markets and moviehouses.

D

Advice them on the signs of German measles.

Question 11 Explanation:

Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to pregnant women.

Question 12

You were invited to be the resource person in a training class for food handlers. Which of the following would you emphasize regarding prevention of staphylococcal food poisoning?

A

All cooking and eating utensils must be thoroughly washed.

B

Proper handwashing during food preparation is the best way of preventing the condition.

C

Food handlers and food servers must have a negative stool examination result.

D

Food must be cooked properly to destroy staphylococcal microorganisms.

Question 12 Explanation:

Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the microorganisms themselves. Contamination is by food handling by persons with staphylococcal skin or eye infections.

Question 13

To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?

A

Mass screening tests

B

Contact tracing

C

Community survey

D

Interview of suspects

Question 13 Explanation:

Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.

Question 14

The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?

A

Stream clearing

B

Stream seeding

C

Zooprophylaxis

D

Destruction of breeding places

Question 14 Explanation:

Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito

Question 15

Among the following diseases, which is airborne?

A

Measles

B

Diphtheria

C

Viral conjunctivitis

D

Acute poliomyelitis

Question 15 Explanation:

Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is spread through the fecal-oral route and contact with throat secretions, whereas diphtheria is through direct and indirect contact with respiratory secretions.

Question 16

In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?

A

Severe febrile disease

B

Severe dehydration

C

Mastoiditis

D

Severe pneumonia

Question 16 Explanation:

The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or effective, tehn urgent referral to the hospital is done.

Question 17

The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsillopharyngitis?

A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?

A

Start the patient on intravenous fluids STAT.

B

Instruct the mother to give the child Oresol.

C

Insert an NGT and give fluids per NGT.

D

Refer the client to the physician for appropriate management.

Question 18 Explanation:

Since the child does not manifest any other danger sign, maintenance of fluid balance and replacement of fluid loss may be done by giving the client Oresol.

Question 19

A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds?

A

10

B

5

C

8

D

3

Question 19 Explanation:

Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.

Question 20

You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take?

A

Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.

B

Ask the client to be accompanied by a significant person before revealing the result.

C

Refer the client to the physician since he is the best person to reveal the result to the client.

D

Get a thorough history of the client, focusing on the practice of high risk behaviors.

Question 20 Explanation:

A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ELISA result was false and that, most probably, the client is not infected.

Question 21

In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?

A

To prevent an outbreak in the community, quarantine may be imposed by health authorities.

B

The older one gets, the more susceptible he becomes to the complications of chicken pox.

C

A single attack of chicken pox will prevent future episodes, including conditions such as shingles.

D

Chicken pox vaccine is best given when there is an impending outbreak in the community.

Question 21 Explanation:

Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.

Question 22

For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?

A

Use of sterile syringes and needles

B

Immediate reporting of water pipe leaks and illegal water connections

C

Proper disposal of human excreta and personal hygiene

D

Safe food preparation and food handling by vendors

Question 22 Explanation:

Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.

Question 23

MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?

A

III

B

I

C

IV

D

II

Question 23 Explanation:

Waterworks systems, such as MWSS, are classified as level III.

Question 24

What is the most effective way of controlling schistosomiasis in an endemic area?

A

Use of protective footwear, such as rubber boots

B

Building of foot bridges

C

Proper use of sanitary toilets

D

Use of molluscicides

Question 24 Explanation:

The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts.

Question 25

In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?

A

Bladder cancer

B

Intestinal perforation

C

Liver cirrhosis

D

Liver cancer

Question 25 Explanation:

The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver.

Question 26

Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?

A

Measles vaccine

B

MMR

C

DPT

D

Oral polio vaccine

Question 26 Explanation:

DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccine are highly sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on Immunization.

Question 27

Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?

A

Hemophilus influenzae

B

Steptococcus pneumoniae

C

Neisseria meningitidis

D

Morbillivirus

Question 27 Explanation:

Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution is not specific in young children.

Question 28

The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.

A

Nasal mucosa

B

Skin on the antecubital surface

C

Buccal mucosa

D

Skin on the abdomen

Question 28 Explanation:

Koplik’s spot may be seen on the mucosa of the mouth or the throat.

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1. In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?

Liver cancer

Liver cirrhosis

Bladder cancer

Intestinal perforation

2. What is the most effective way of controlling schistosomiasis in an endemic area?

Use of molluscicides

Building of foot bridges

Proper use of sanitary toilets

Use of protective footwear, such as rubber boots

3. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is

I

II

III

IV

4. For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?

Use of sterile syringes and needles

Safe food preparation and food handling by vendors

Proper disposal of human excreta and personal hygiene

Immediate reporting of water pipe leaks and illegal water connections

5. Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?

DPT

Oral polio vaccine

Measles vaccine

MMR

6. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.

45

50

55

60

7. In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?

Mastoiditis

Severe dehydration

Severe pneumonia

Severe febrile disease

8. A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds?

3

5

8

10

9. A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?

Insert an NGT and give fluids per NGT.

Instruct the mother to give the child Oresol.

Start the patient on intravenous fluids STAT.

Refer the client to the physician for appropriate management.

10. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.

Nasal mucosa

Buccal mucosa

Skin on the abdomen

Skin on the antecubital surface

11. Among the following diseases, which is airborne?

Viral conjunctivitis

Acute poliomyelitis

Diphtheria

Measles

12. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?

Hemophilus influenzae

Morbillivirus

Steptococcus pneumoniae

Neisseria meningitidis

13. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?

Stream seeding

Stream clearing

Destruction of breeding places

Zooprophylaxis

14. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?

Stream seeding

Stream clearing

Destruction of breeding places

Zooprophylaxis

15. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?

Use of chemically treated mosquito nets

Seeding of breeding places with larva-eating fish

Destruction of breeding places of the mosquito vector

Use of mosquito-repelling soaps, such as those with basil or citronella

16. A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The client is most probably suffering from which condition?

Giardiasis

Cholera

Amebiasis

Dysentery

17. In the Philippines, which specie of schistosoma is endemic in certain regions?

S. mansoni

S. japonicum

S. malayensis

S. haematobium

18. A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?

Hepatitis A

Hepatitis B

Tetanus

Leptospirosis

19. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?

I

II

III

IV

20. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take?

Get a thorough history of the client, focusing on the practice of high risk behaviors.

Ask the client to be accompanied by a significant person before revealing the result.

Refer the client to the physician since he is the best person to reveal the result to the client.

Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.

21. Which is the BEST control measure for AIDS?

Being faithful to a single sexual partner

Using a condom during each sexual contact

Avoiding sexual contact with commercial sex workers

Making sure that one’s sexual partner does not have signs of AIDS

22. The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsillopharyngitis?

Respiratory candidiasis

Infectious mononucleosis

Cytomegalovirus disease

Pneumocystis carinii pneumonia

23. To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?

Contact tracing

Community survey

Mass screening tests

Interview of suspects

24. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs.

They prolong the life of the client with AIDS.

They reduce the risk of opportunistic infections

They shorten the period of communicability of the disease.

They are able to bring about a cure of the disease condition.

25. A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the first trimester of pregnancy in the barangay?

Advice them on the signs of German measles.

Avoid crowded places, such as markets and moviehouses.

Consult at the health center where rubella vaccine may be given.

Consult a physician who may give them rubella immunoglobulin.

26. You were invited to be the resource person in a training class for food handlers. Which of the following would you emphasize regarding prevention of staphylococcal food poisoning?

All cooking and eating utensils must be thoroughly washed.

Food must be cooked properly to destroy staphylococcal microorganisms.

Food handlers and food servers must have a negative stool examination result.

Proper handwashing during food preparation is the best way of preventing the condition.

27. In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?

The older one gets, the more susceptible he becomes to the complications of chicken pox.

A single attack of chicken pox will prevent future episodes, including conditions such as shingles.

To prevent an outbreak in the community, quarantine may be imposed by health authorities.

Chicken pox vaccine is best given when there is an impending outbreak in the community.

28. Complications to infectious parotitis (mumps) may be serious in which type of clients?

Pregnant women

Elderly clients

Young adult males

Young infants

Answers and Rationales

Answer: (B) Liver cirrhosis. The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver.

Answer: (C) Proper use of sanitary toilets. The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts.

Answer: (B) II. A communal faucet or water standpost is classified as Level II.

Answer: (A) Use of sterile syringes and needles. Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.

Answer: (A) DPT. DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccine are highly sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on Immunization.

Answer: (A) 45. To estimate the number of infants, multiply total population by 3%.

Answer: (B) Severe dehydration. The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or effective, tehn urgent referral to the hospital is done.

Answer: (A) 3. Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.

Answer: (B) Instruct the mother to give the child Oresol. Since the child does not manifest any other danger sign, maintenance of fluid balance and replacement of fluid loss may be done by giving the client Oresol.

Answer: (B) Buccal mucosa. Koplik’s spot may be seen on the mucosa of the mouth or the throat.

Answer: (D) Measles. Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is spread through the fecal-oral route and contact with throat secretions, whereas diphtheria is through direct and indirect contact with respiratory secretions.

Answer: (A) Hemophilus influenzae. Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution is not specific in young children.

Answer: (D) Zooprophylaxis. Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing infection of humans.

Answer: (A) Stream seeding. Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito

Answer: (B) Cholera. Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea.

Answer: (B) S. japonicum. S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S. malayensis only in peninsular Malaysia.

Answer: (D) Leptospirosis. Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.

Answer: (C) III. Waterworks systems, such as MWSS, are classified as level III.

Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false. A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ELISA result was false and that, most probably, the client is not infected.

Answer: (A) Being faithful to a single sexual partner. Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.

Answer: (A) Contact tracing. Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.

Answer: (D) They are able to bring about a cure of the disease condition. There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life, but does not cure the underlying immunodeficiency.

Answer: (D) Consult a physician who may give them rubella immunoglobulin. Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to pregnant women.

Answer: (D) Proper handwashing during food preparation is the best way of preventing the condition. Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the microorganisms themselves. Contamination is by food handling by persons with staphylococcal skin or eye infections.

Answer: (A) The older one gets, the more susceptible he becomes to the complications of chicken pox. Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.

Answer: (C) Young adult males. Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.